Childhood adversity—such as child abuse, exposure to violence, family alcohol or drug abuse, and poverty—can have negative, long-term impacts on health and well being (1, 2). Nearly half of U.S. children have experienced at least one adverse childhood event (3). Early experiences affect brain structure and function, which provide the foundation for learning, emotional development, behavior, and health (4). The toxic stress associated with traumatic, and often cumulative, early adverse experiences can disrupt healthy development and lead to behavioral, emotional, school, and health problems during childhood and adolescence (2, 3, 5, 6). It also can lead to serious behavioral, emotional, and health issues in adulthood, such as chronic diseases, obesity, alcohol and other substance abuse, and depression (1, 2, 3). The more traumatic and toxic events experienced by a child, the more likely the impact will be substantial and long-lasting (7).

Resilience, an adaptive response to hardship, can mitigate the effects of adverse childhood experiences (6, 8). It is a process of adapting well in the face of adversity, trauma, threats, or other significant sources of stress. Resilience involves a combination of internal and external factors. Internally, it involves behaviors, thoughts, and actions that anyone can learn and develop. Resilience is also strengthened by having safe, stable, nurturing relationships and environments within and outside the family (6, 8, 9).

For more information on childhood adversity and resilience, see kidsdata.org’s Research & Links section.

Childhood adversity is common among California children, and many children experience multiple traumatic and negative events. The most timely assessment of childhood resilience and adversity comes from the National Survey of Children's Health (NSCH), in which parents report on the current status of their children. NSCH data from 2016 show that 52% of California children were resilient while 16% of children had experienced two or more adverse childhood events. According to the 2013-2014 Maternal and Infant Health Assessment (MIHA), 25% of postpartum women in California experienced two or more childhood hardships before age 14. The California Behavioral Risk Factor Surveillance System Adverse Childhood Experiences (ACEs) Module, combining data from 2008 to 2013, shows that 17% of adults in households with children experienced at least four ACEs before age 18.

The percentage of postpartum women who experience two or more childhood hardships varies by poverty level and maternal age. According to 2013-2014 MIHA data, among poor women (i.e., those with family incomes up through 100% of the federal poverty guideline), 34% experienced two or more hardships as children, compared with 16% of higher-income women (i.e., those with family incomes over 200% of the federal poverty guideline). Furthermore, one-third of young mothers 15-19 years old experienced two or more hardship as children (33%), compared with less than one-fifth of mothers 35 years old and older (19%).

Policy Implications

In recent years, policymakers, researchers, and advocates increasingly have focused on childhood adversity (e.g., physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship), recognizing that such experiences can have harmful, lifelong consequences (1, 2). For example, children exposed to multiple adverse childhood experiences (ACEs) are more likely to develop negative health behaviors and chronic diseases in adulthood (1). Unaddressed ACEs place strain on public systems, including child welfare, education, health care, and juvenile justice (1). Policymakers have a role in helping to prevent ACEs, as well as in ensuring early identification and intervention for parents and children affected by trauma. While California has made strides in these areas, continued efforts are needed to ensure that all families have the opportunity to help their children thrive and reach their full potential (1, 3).

Policy and program options to help prevent, interrupt, and mitigate the effects of childhood adversity include:

Raising public awareness about ACEs and their negative, lasting effects on children and families (1)

Ensuring effective prevention services are in place, including strength-based parenting education, family support, and home-visiting services for families in need (4)

Promoting policies that help reduce family stress and increase stability for children, e.g., policies to improve the social safety net for families in need, support family-friendly business practices, and ensure quality child care is affordable and accessible (4)

Institutionalizing trauma-informed policies and practices for public and private systems and organizations (designed specifically to address the consequences of trauma and facilitate resilience and healing), including screening and intervention with health reimbursement mechanisms (1, 3)

Supporting formal workforce education about ACEs and trauma-informed approaches for professionals who work with families and children, such as administrators, doctors, nurses, educators, social workers, and juvenile justice staff (1, 3)

Promoting increased collaboration across organizations and systems (e.g., local and state government, education, health care, juvenile justice, child welfare, and nonprofits) to address systemic barriers to preventing or treating trauma and toxic stress, including improving service coordination, sharing data, and aligning measures of success (1, 4)